crossing96/oncoscreening huggingface dataset:
[Initial experience in the diagnosis and treatment of superficial bladder tumors with Hexvix].	OBJECTIVES: White light cystoscopy is the current standard for the diagnosis of bladder cancer and monitorization for recurrence. Recent studies suggest that porphyrin based fluorescence cystoscopy may improve endoscopic detection of bladder tumors. We aimed to evaluate the improvement that hexaminolevulinate fluorescence cystoscopy could lead in bladder cancer detection and treatment at one single centre. METHODS: Between September 2006 and September 2007 a total of 39 patients with known or suspected bladder cancer underwent bladder instillation with 50 ml 8 mM hexaminolevulinate (HAL) for 1 hour. The bladder was inspected using white light cystoscopy (WLC), followed by blue light (fluorescence) cystoscopy (BLC). Papillary and suspicious lesions were resected for histological examination. Mean age was 70.1 years (50-86). Thirty patients were male (76.9%) and 9 female (23.1%). The tumor characteristics were: 18% primary tumors, 51% recurrences and 30% control cystoscopies. 24 patients had previously received some treatment (9 MMC and 15 BCG). Only 7 patients had previous positive urine cytology. RESULTS: All papillary lesions visualized with WLC were confirmed by BLC (18 patients). From these, 17 have positive biopsies (6 pTaG1, 9 pT1G1-3, 1 pT2, 1 CIS). In 15 patients (38.4%) we found at least 1 lesion more with BLC. In this group 8 cases (20.5%) had positive histological diagnosis (3 pTaG1, 2 pT1G3, 3 CIS). In five patients (13%) post-TUR therapeutic management has changed by using BLC (BCG vs MMC). All four patients with CIS were diagnosed by BLC. There was no evidence of local or systemic side effects due to HAL in the postoperative time. CONCLUSIONS: Our results suggest there is an improvement in the diagnosis of papillary and flat lesions in bladder cancer by using HAL fluorescence cystoscopy. This has changed the management in the postoperative period (MMC vs BCG) in 13% of the patients. Obviously, we need more patients to assess our data and long-term follow-up to analyze the impact in terms of tumor recurrence and progression.	bladder
Overexpression of BMI1, a polycomb group repressor protein, in bladder tumors: a preliminary report.	INTRODUCTION: A Polycomb group repressor protein named BMI1 represses the genes that induce cellular senescence and cell death, and it can contribute to cancer when improperly expressed. We aimed to evaluate expression of BMI1 gene in bladder tumors. MATERIALS AND METHODS: Tissue specimens containing bladder tumor were evaluated and compared with intact tissues from tumor margins and normal bladders. There were 40 tumor specimens of patients with transitional cell carcinoma of the bladder, 20 tumor-free tissues taken from the margin of the tumors, and 8 specimens from patients without tumor. Specific primers for BMI1 and B2M (as an internal control) were used for reverse transcript polymerase chain reaction technique. The production and distribution of BMI1 protein was also examined by western blotting and immunohistochemistry techniques. RESULTS: Polymerase chain reaction generated a 683-bp product, corresponding to the expected size of BMI1 amplified region. The identity of the amplified fragment was then confirmed by direct DNA sequencing. The mean of expression of BMI1 detected in tumor tissues was significantly higher than that in intact tissues, and there was also a significant association between the mean of gene expression and the stage of malignancy (P < .001). The expression of BMI1 at protein level was further confirmed by western blotting and immunohistochemistry. CONCLUSION: BMI1 is a potent repressor of retinoblastoma and p53 pathways, and hence, elucidating its role in tumorigenesis is very important. We reported for the first time the expression of BMI1 and its correlation with incidence and progress of bladder tumors.	bladder
Predicting tumor outcomes in urothelial bladder carcinoma: turning pathways into clinical biomarkers of prognosis.	Molecular markers have potential as both diagnostics and predictors of progression and patient outcome in urothelial cancer. Advancements in technology have provided an understanding of the molecular mechanisms of carcinogenesis and defined distinct pathways in tumorigenesis and progression. Herein we present a select overview of the molecular underpinning of urothelial carcinogenesis and progression, and discuss the potential for some of the proteins involved in these processes to serve as biomarkers for evaluation of progression risk. Eventual refinement of prognostic methods with the addition of the latter markers will enable clinicians to provide an individualized therapeutic approach for each patient, and discover targets for novel therapeutic agents to disrupt the deregulation underlying the development and progression of urothelial carcinogenesis.	bladder
Risk factors and clinical outcomes of patients with node-positive muscle-invasive bladder cancer.	Radical cystectomy and lymphadenectomy is a standard treatment for patients with high-grade, invasive bladder cancer. Although the absolute limits of lymphadectomy at the time of surgery have not been precisely defined, there is a growing body of evidence to suggest that an extended lymph node dissection may be beneficial for staging and survival in both node-negative and -positive bladder cancer patients. For lymph node-positive patients, several prognostic factors have been identified to provide risk stratification and direct the need for adjuvant treatment. These include: the pathological stage of the bladder tumor, extent of the lymphadenectomy and nodal tumor burden. The concept of lymph node density has also been identified as a prognostic factor. The literature and data on the extent of lymphadenectomy will be reviewed as well as the current prognostic variables and the benefits of adjuvant chemotherapy.	bladder
Does the expression of fascin-1 and tumor subclassification help to assess the risk of recurrence and progression in t1 urothelial urinary bladder carcinoma?	INTRODUCTION: To evaluate the prognostic value of T1 subclassification and fascin-1 expression in T1 human urothelial cell carcinoma of the bladder. MATERIALS AND METHODS: In a prospective study with 105 consecutive patients, T1 tumors were subclassified into 2 groups according to the depth of tumor invasion. The tunica muscularis mucosae was used as a landmark. The expression of fascin-1 was examined by using an anti-fascin-1 mouse monoclonal antibody and was evaluated semiquantitatively for both intensity and distribution. The patients were followed up for 27.3 +/- 13.7 months. RESULTS: The T1 tumor subclassification was feasible in 99 patients (94%). T1a tumor was detected in 77 patients (73%), T1b tumor in 22 patients (21%). An invasive tumor was found in 5 patients (4.8%) during the restaging transurethral resection of the bladder. The risk of understaging in patients with T1b tumor was 18%. There was not a significant difference in time to the recurrence in the T1a and the T1b group. The progression-free survival rates were significantly different between both groups (p = 0.0034). No correlation was found between fascin-1 positivity and the depth of tumor invasion. Fascin-1 positivity did not correlate with recurrence or the progression-free intervals. In the multivariate analysis, only the extent of lamina propria invasion was an independent predictor of the tumor progression. The fascin positivity was not an independent prognostic factor relating to the risk of recurrence or progression. CONCLUSION: The finding of T1b tumor was connected with a significantly higher risk of progression and understaging. The fascin-1 expression did not correlate with the depth of tumor invasion or with the tumor recurrence or progression.	bladder
Is robotic radical cystectomy an appropriate treatment for bladder cancer? Short-term oncologic and clinical follow-up in 50 consecutive patients.	OBJECTIVES: Recent case series have now been reported for robotic cystectomy. Despite the novelty of these approaches, few reports have been published on the oncologic and clinical outcomes, even in the short term. We report the oncologic and short-term clinical outcomes of 50 patients who underwent robotic-assisted radical cystectomy. METHODS: A total of 50 patients underwent robotic-assisted laparoscopic radical cystectomy and extracorporeal urinary diversion for bladder cancer. The outcome measures included the pathologic outcomes, complication rate, timing of adjuvant chemotherapy, disease recurrence, and overall and disease-specific survival. RESULTS: Robotic cystectomy was performed in 40 men and 10 women at a mean age of 63.6 years. Of the 50 patients, 66% had Stage pT2 or less, 14% had pT3 disease, and 20% Stage N+ disease. No patient had positive surgical margins. The mean number of lymph nodes removed was 19 (range 8-37). The mean clinical follow-up was 13.2 months. Seven patients had evidence of recurrent disease. Three patients died of advanced urothelial carcinoma, and two died of other causes. Longer term complications included stomal hernia in 2 and partial ureteral obstruction in 1. Eleven patients underwent adjuvant chemotherapy for Stage pT3 disease and N+ disease at a mean of 7.2 weeks postoperatively. CONCLUSIONS: The clinical and oncologic follow-up of patients undergoing robotic radical cystectomy appears to be favorable in the short term. As our follow-up increases, we should expect to continue to truly define the long-term clinical appropriateness and oncologic success of this procedure.	bladder
[Management of Ta, T1, and in situ bladder carcinoma: what is new?].	Since a recent time, some changes were made in the management of nonmuscle-invasive bladder cancer. Second-look resection is efficient in patients with high risk superficial tumors. The interest of resection under fluorescence is still discussed. The new classification in high grade and low grade tumors is progressively replacing the G1-G2-G3 grade classification. New prognosis markers appear such as lamina propria invasion microstaging and prostatic urethra involvement. Immediate postoperative instillation of chemotherapy decreases the risk of recurrence in patients with stage Ta T1 bladder cancer. Intravesical Mitomycin C can be optimized to significantly enhance its efficacy. Intravesical Bacillus Calmette-Guérin (BCG) appears to be the treatment of choice for the management of carcinoma in situ, and is superior to Mitomycin C in reducing tumor recurrence in high-risk nonmuscle-invasive bladder cancer. In addition, intravesical BCG significantly reduces the risk of progression after transurethral resection in patients with nonmuscle-invasive bladder cancer who receive maintenance treatment.	bladder
[Prevention of Bacillus Calmette-Guérin immunotherapy complications].	Bacille Calmette-Guérin (BCG) in intravesical instillations is the reference treatment for urothelial carcinoma with a high risk of progression. Compliance with this treatment is altered by its potentially serious locoregional or general side effects. Prevention of these complications requires implementing rules of good practice for the instillations. The undesirable side effects should be recognized early. Their treatment should be rapid and adapted to the patient. The results of the French randomized, placebo-controlled ITB01 study showed that the class II side effects of BCG were significantly reduced by administration of ofloxacin after each instillation of BCG. The number of class III side effects requiring antitubercular treatment was also reduced in the patients in this study who had received ofloxacin.	bladder
Nomograms for prediction of disease recurrence in patients with primary Ta, T1 transitional cell carcinoma of the bladder.	We developed nomograms to predict disease recurrence in patients with Ta, T1 transitional cell carcinoma of the bladder. Thirty-eight training hospitals participated in this retrospective multicenter study. Between 1998 and 2002, a total of 1,587 patients with newly diagnosed non-muscle invasive bladder cancer were enrolled in this study. Patients with prior histories of bladder cancer, non-transitional cell carcinoma, or a follow-up duration of less than 12 months were excluded. With univariate and multivariate logistic regression analyses, we constructed nomograms to predict disease recurrence, and internal validation was performed using statistical techniques. Three-year and five-year recurrence-free rates were 64.3% and 55.3%, respectively. Multivariate analysis revealed that age (hazard ratio [HR]=1.437, p<0.001), tumor size (HR=1.328, p=0.001), multiplicity (HR=1.505, p<0.001), tumor grade (HR=1.347, p=0.007), concomitant carcinoma in situ (HR=1.611, p=0.007), and intravesical therapy (HR=0.681, p<0.001) were independent predictors for disease recurrence. Based on these prognostic factors, nomograms for the prediction of disease recurrence were developed. These nomograms can be used to predict the probability of disease recurrence in patients with newly diagnosed Ta, T1 transitional cell carcinoma of the bladder. They may be useful for patient counseling, clinical trial design, and patient follow-up planning.	bladder
A series of vascular tumors and tumorlike lesions of the bladder.	Vascular tumors of the bladder are rare and a subject of small series and case reports. We retrospectively identified vascular tumors of the urinary bladder from the consultation files from one of the authors. We identified 13 lesions that included 3 hemangiomas, 3 intravascular papillary endothelial hyperplasias (Masson vegetant hemangioendotheliomas), 2 arteriovenous malformations (AVMs), 1 epithelioid hemangioendothelioma (EHE), and 4 angiosarcomas. One of the angiosarcomas was associated with conventional high-grade urothelial carcinoma (sarcomatoid carcinoma). All patients were adults with a range in age from 18 to 85 years old (mean 63.3). There was no statistical difference among the various lesions in terms of age, although angiosarcomas tended to arise in older patients (mean 71 y vs. 60 y of the remainder). Hematuria was the most common presentation of both benign and malignant lesions. Other symptoms included voiding irritation, pelvic pain, and obstruction. Histologically, benign and malignant lesions were similar to their counterparts in other organ systems. Two hemangiomas were of the capillary type and a third one of the cavernous subtype. They measured 1.1, 2.4, and 3.2 cm. Both AVMs were clinically large broad-based masses measuring 5.5 and 5.8 cm in greatest diameter. One of the AVMs was associated with pseudoepitheliomatous hyperplasia of the urothelium. All 3 patients with Masson lesion had history of radiation therapy for other causes. These presented as raised lesions and were all <1.0 cm. Patients with hemangiomas, papillary endothelial hyperplasias, and AVM had an invariably benign prognosis and needed no further therapy. These benign lesions had consistent involvement of the submucosa and spared the muscularis propria of the organ. All cases of angiosarcoma and EHE involved the muscularis propria. Two of four patients with angiosarcoma had a history of prior radiation therapy and all 4 were dead of disease at 6 months. Angiosarcomas measured 3, 4.5, 5, and 5.8 cm in greatest diameter at cystoscopy. The patient with EHE had a single nodule treated by transurethral resection of the bladder and no evidence of disease at 4 years of follow-up. None of the patients experienced marked gross hematuria that resulted in morbidity or mortality. A wide spectrum of benign, intermediate malignant, and malignant vascular lesions primarily involved the bladder. Despite the potential for marked hemorrhage, none of the tumors resulted in marked hematuria. Papillary endothelial hyperplasia occurs in the bladder and must be differentiated from angiosarcoma, which has a rapidly fatal outcome.	bladder
[Why and how to modify standard cystectomy].	To improve quality of life in postcystectomy patients, we made 150 radical cystectomies with recovery of urethral voiding. Cystectomy was performed by a modified technique in 87 of 135 operated men: transprostatic cystvesiculectomy (n = 11), transprostatic cystectomy (n = 53), supraprostatic cystectomy (n = 23). Indication for this modification was the absence of extravesicular growth of the primary tumor and prostatic cancer. Monitoring of radicalism was carried out by intraoperative urgent histological investigation of the resection line. 74 patients have undergone retrograde cystectomy. Postoperative lethality was 2.3%. 9 month and longer follow up results were studied.	bladder
Identification of bladder cancer patients at risk for recurrence or progression: an immunohistochemical study based on the expression of metallothionein.	Despite similarities in tumor stage and grade the individual outcome of bladder cancer patients is not predictable. The ideal tool for treatment stratification has not yet been found. Metallothionein (MT) overexpression is correlated with poor tumor differentiation, resistance to chemotherapy, and impaired survival in different malignancies. The clinical relevance of MT expression for defining patients at high risk for recurrence or progression was assessed. MT was detected immunohistochemically and evaluated semiquantitively in tumor specimens of 103 male and 19 female patients (transsurethral resection: n = 94, cystectomy: n = 28). Mean age of the patients was 68 (38-87) yr. According to histopathological features, three groups were distinguished for further analysis (pTa-1G1-2, pTis/pT1G3, and muscle invasive tumors). A cutoff value of 50% immunoreactive cells was used for further analysis. The 5-yr tumor specific survival rate was significantly lower in patients with high MT expression (32 vs. 72%). Accordingly, impaired 5-yr recurrence (90 vs. 58%), and progression rates (78 vs. 54%) were associated with high MT expression. All patients suffering from pTis and pT1G3 tumors with MT expression above the cutoff value showed recurrence within less than 40 mo, whereas 26% of those patients with MT expression below the cutoff value remained long-term recurrence free. Long term progression free survival was detected in 75% of pT1G3 patients with MT expression below the cutoff value. In contrast, 68% of pT1G3 tumor patients with MT expression above the cutoff value progressed, all within the first 12 mo after initial tumor resection. A correlation between high MT expression and prognosis was demonstrated especially in pT1G3 and pTis tumors, where >50% MT expression was linked to shorter tumor-specific survival and increased recurrence/progression rates. Thus, MT expression seems to be a promising marker for further risk stratification in the clinical treatment of bladder cancer patients.	bladder
The influence of polymorphisms of glutathione S-transferases M1 and M3 on the development of human urothelial cancer.	Cigarette smoking is the most important risk factor for development of transitional cell carcinoma of the urinary bladder. The effect of polymorphisms of glutathione S-transferases M1 (GSTM1) and M3 (GSTM3) on the influence of cigarette smoking on urinary bladder carcinogenesis was investigated. In total, 293 bladder cancer patients from hospitals in Dortmund and Wittenberg as well as 176 patients without any malignancy from a Department of Surgery from Dortmund were genotyped for GSTM1 and GSTM3 according to standard PCR/RFLP methods. Smoking habits were quantified by a standardized interview. The proportion of GSTM1 negative cases was 63% in the entire bladder cancer cases group compared to 50% in controls. The GSTM3*A/*A genotype was 76% in cancer cases versus 74% in controls. Smokers and ex-smokers were overrepresented in bladder cancer cases. A significant association between smoking status and GSTM1 or GSTM3 genotype was not detected. The elevated proportion of GSTM1 negative bladder cancer cases shows an effect of this polymorphic enzyme on development of bladder cancer. In contrast to other studies, an influence of GSTM1 on the risk due to cigarette smoking was not observed.	bladder
Elevated bladder cancer risk due to colorants--a statewide case-control study in North Rhine-Westphalia, Germany.	Occupational exposure to aromatic amines is a known bladder cancer risk factor, whereas the impact of exposure to azo dyes, which may release aromatic amines in humans, is at present controversial. Therefore, the impact of occupational exposures to colorants was investigated in 156 bladder cancer cases and 336 controls in the state of North Rhine-Westphalia. All bladder cancer cases and controls (diagnosed with prostate cancer) requested after-care treatment. The subjects were investigated using a questionnaire for all occupations ever performed for more than 6 mo and for exposures to several possible occupational and nonoccupational bladder carcinogens. The relative bladder cancer risk was adjusted for age and smoking. The adjusted odds ratio (OR) for bladder cancer was elevated in 7 painters (OR 1.98, 95% CI 0.64-6.11), 4 hairdressers (OR 4.9, 95% CI 0.85-28.39), and 16 cases who reported a wood processing occupation (OR 1.19, 95% CI 0.58-2.41). Ten of these 16 cases reported chronic exposure to colorants (OR 1.84, 95% CI 0.68-4.95). The results of this epidemiological study confirm the hypothesis that individuals exposed to colorants show an elevated bladder cancer risk.	bladder
Thulium laser resection via a flexible cystoscope for recurrent non-muscle-invasive bladder cancer: initial clinical experience.	OBJECTIVE: To present our initial experience of thulium laser resection via a flexible cystoscope for recurrent non-muscle-invasive bladder cancer (ThuRBT), as transurethral resection for bladder tumour (TURBT) is regarded as the reference standard for treating this disease, but alternative laser resection or ablation is suitable especially for recurrent tumours. PATIENTS AND METHODS: From January 2005 to October 2005, 32 patients with early recurrent bladder tumour (recurrent within a year after TURBT) were treated with ThuRBT via a flexible cystoscope. The follow-up included urine analysis, ultrasonography and cystoscopy every 3 months. RESULTS: All patients were treated successfully with ThuRBT in one session, with no bladder haemorrhage, obturator nerve reflex or vesicle perforation. Randomized biopsies taken after surgery on and adjacent to the resection surface revealed no residual tumours. The mean (range) tumour diameter was 1.5 (0.5-3) cm and the mean operative duration was 25 (15-35) min. During the first year of follow-up, local and heterotopic recurrences were found in three and six patients, respectively. The accumulated recurrence rates at 3, 6 and 12 months were 9%, 22% and 28%, respectively. CONCLUSIONS: ThuRBT is a reliable therapy with minimal morbidity and invasiveness for selected patients with bladder cancer.	bladder